Clinical experiences of treating septic arthritis in the equine by repeated joint lavage: a series of 39 cases.
Abstract: The condition of septic arthritis was treated in 12 foals with 21 affected joints (Group I) and in 27 adult horses. The adult horses were divided into three groups, based on aetiology of the condition: haematogenous (Group II, n = 6), iatrogenic (Group III, n = 6), and perforating trauma (Group IV, n = 15). The treatment consisted of an initial systemic antibiotic that anticipated the microbial agents that were considered most likely per group, repeated through-and-through joint lavages every other day and non-steroidal anti-inflammatory drugs. The antibiotics were adjusted to the results of bacteriological culture and susceptibility tests. Joint lavages were continued until the white blood cell count dropped below 15 G/l and bacteriological culture was negative, after which a single dose of a short-acting corticosteroid was administered intra-articularly. Joint recovery rate in group I was 71%. Patient recovery rate of the foals, however, was lower (42%). Three foals were killed for reasons other than arthritis; one foal because of an arthritis-related problem and three foals because of persistent arthritis. Overall joint recovery rate, equalling patient recovery rate, in the adult horses was 81%. The expected predominance of Streptococcus spp. in haematogenous arthritis in adult horses was not confirmed, indicating that in these cases also, an initial antibiotic treatment with a broad-spectrum combination is preferable. It is concluded that with intensive treatment, the prognosis of septic arthritis in the adult horse can be classified as fair to even good. Results in the foals are not as good, but this seems to be more due to the specific problems surrounding the equine neonate than to unresponsiveness to the treatment.
Publication Date: 2000-09-29 PubMed ID: 11008444DOI: 10.1046/j.1439-0442.2000.00290.xGoogle Scholar: Lookup
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- Journal Article
Summary
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The study investigates the treatment outcomes of septic arthritis in 12 foals and 27 adult horses. The researchers used systemic antibiotics, joint lavage, and anti-inflammatory drugs, with treatment success varying across age groups, and particularly affected by the cause of septic arthritis in adult horses.
Treatment Method and Groups
- The study subjects included 21 joints from 12 foals (Group I) and 27 adult horses divided into three groups based on the cause of their septic arthritis (Groups II-IV): blood-borne, iatrogenic (caused by medical treatment), and traumatic penetration.
- Treatment comprised initial systemic antibiotics, guessed on the most probable microbial agents for each group, non-steroidal anti-inflammatory drugs, and a thorough and repeated joint lavage done every other day.
- The antibiotics were modified depending on bacteriological culture and susceptibility test results.
- Joint lavages were carried out until there was a drop in the white blood cell count below 15 G/l and a negative bacteriological culture, followed by a single dose of short-acting corticosteroid administered intra-articularly.
Findings and Prognosis
- The joint recovery rate in foals (Group I) was 71%, but their patient recovery rate was much lower, at 42%. Three of these foals were killed due to reasons other than arthritis. One foal was killed because of an arthritis-related problem and another three due to persistent arthritis.
- The joint recovery rate in adult horses, which equaled their patient recovery rate, was 81%.
- The researchers found that Streptococcus spp., usually expected to predominate in adult horses’ blood-borne septic arthritis, wasn’t confirmed, suggesting a broad-spectrum antibiotic combination is preferable for initial treatment in such cases.
- The researchers concluded that intensive treatment provides a fair to good prognosis for septic arthritis in adult horses, but results were not as encouraging in foals. The lower success rate in foals was attributed more to specific problems related to newborn horses than to unresponsiveness to the treatment.
Cite This Article
APA
Meijer MC, van Weeren PR, Rijkenhuizen AB.
(2000).
Clinical experiences of treating septic arthritis in the equine by repeated joint lavage: a series of 39 cases.
J Vet Med A Physiol Pathol Clin Med, 47(6), 351-365.
https://doi.org/10.1046/j.1439-0442.2000.00290.x Publication
Researcher Affiliations
- Department of Equine Sciences, Faculty of Veterinary Medicine, University of Utrecht, The Netherlands. M.C.Meijer@vet.uu.nl
MeSH Terms
- Ampicillin / administration & dosage
- Ampicillin / therapeutic use
- Animals
- Anti-Infective Agents / administration & dosage
- Anti-Infective Agents / therapeutic use
- Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
- Arthritis, Infectious / microbiology
- Arthritis, Infectious / therapy
- Arthritis, Infectious / veterinary
- Bacterial Infections / microbiology
- Bacterial Infections / therapy
- Bacterial Infections / veterinary
- Europe
- Female
- Gentamicins / administration & dosage
- Gentamicins / therapeutic use
- Horse Diseases / microbiology
- Horse Diseases / therapy
- Horses
- Male
- Penicillins / administration & dosage
- Penicillins / therapeutic use
- Therapeutic Irrigation / methods
- Therapeutic Irrigation / veterinary
- Trimethoprim, Sulfamethoxazole Drug Combination / administration & dosage
- Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use
Citations
This article has been cited 14 times.- Beggan CP, Panizzi L, Oliver LJ. Efficacy of needle and endoscopic lavage on the recuperation of microspheres from the adult equine metacarpo-/metatarsophalangeal joint and digital flexor tendon sheath. Vet Surg 2025 Aug;54(6):1157-1166.
- Albanese V, Straticò P, Fischer H, Petrizzi L. Equine Distal Limb Wounds: Economic Impact and Short-Term Prognosis of Non-Synovial Versus Synovial Lesions in Southern Germany. Vet Sci 2025 Mar 1;12(3).
- Jimenez Rihuete P, Martin C, Villarino NF, Rubio-Martínez LM. Effect of silica-sprayed collection tubes on synovial fluid bacterial culture. Vet Med Sci 2024 Jul;10(4):e1501.
- Avellar HK, Lutter JD, Ganta CK, Beard W, Smith JR, Jonnalagadda N, Peloquin S, Kang Q, Ayub K. In vitro antimicrobial activity of equine platelet lysate and mesenchymal stromal cells against common clinical pathogens. Can J Vet Res 2022 Jan;86(1):59-64.
- Taylor S. A review of equine sepsis. Equine Vet Educ 2015 Feb;27(2):99-109.
- Hudson BJ, Chicken C, Blishen A, Todhunter KH, Begg AP, Chan L, Karagiannis T, Raymond B, Bogema D, Adkins AR, O'Sullivan CB, O'Rourke BA, Roy Chowdhury P, Djordjevic SP, Charles IG, Edgar A, Mitsakos K. Osteoarticular Infection in Three Young Thoroughbred Horses Caused by a Novel Gram Negative Cocco-Bacillus. Case Rep Vet Med 2020;2020:9785861.
- Crosby DE, Labens R, Hughes KJ, Nielsen S, Hilbert BJ. Factors Associated With Survival and Return to Function Following Synovial Infections in Horses. Front Vet Sci 2019;6:367.
- Andreassen SM, Vinther AML, Nielsen SS, Andersen PH, Tnibar A, Kristensen AT, Jacobsen S. Changes in concentrations of haemostatic and inflammatory biomarkers in synovial fluid after intra-articular injection of lipopolysaccharide in horses. BMC Vet Res 2017 Jun 19;13(1):182.
- Haltmayer E, Schwendenwein I, Licka TF. Course of serum amyloid A (SAA) plasma concentrations in horses undergoing surgery for injuries penetrating synovial structures, an observational clinical study. BMC Vet Res 2017 May 22;13(1):137.
- Zhai H, Pan J, Pang E, Bai B. Lavage with allicin in combination with vancomycin inhibits biofilm formation by Staphylococcus epidermidis in a rabbit model of prosthetic joint infection. PLoS One 2014;9(7):e102760.
- Lamb L, Zubrod C, Hague B, Brakenhoff J, Major M. Clinical outcome of collateral ligament injuries of the tarsus. Can Vet J 2012 May;53(5):518-24.
- Achard D, Francoz D, Desrochers A, Girard C, Piché C. Synovitis induced by joint lavage with hypertonic saline solutions in healthy dairy calves. Can J Vet Res 2012 Apr;76(2):81-90.
- Vos NJ, Ducharme NG. Analysis of factors influencing prognosis in foals with septic arthritis. Ir Vet J 2008 Feb 1;61(2):102-6.
- Francoz D, Desrochers A, Latouche JS. Effect of repeated arthrocentesis and single joint lavage on cytologic evaluation of synovial fluid in 5 young calves. Can J Vet Res 2007 Apr;71(2):129-34.
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